In German-speaking countries, there have been concerted and successful attempts to prevent any discussion of euthanasia from taking place. Both the present writers have been invited to give lectures on this topic, and had these lectures cancelled at short notice because of this opposition. Against that background, we welcome Pauer-Studer’s airing of these issues, and her clear statement that attempts to prevent advocates of euthanasia from speaking are “definitely unacceptable.” Nevertheless, we find much that Pauer-Studer says to be in error.

Few subjects have generated so many newspaper headlines and such heated controversy as the treatment, or non-treatment, of handicapped newborns. In 1982, the case of Baby Doe, a child born with Down's syndrome, stirred up a national debate in the United States, while in Britain a year earlier, Dr. Leonard Arthur stood trial for his decision to allow a baby with Down's syndrome to die. Government intervention and these recent legal battles accentuate the need for a reassessment of the complex (...) issues involved. This volume--by two authorities on medical ethics--presents a philosophical analysis of the subject based on particular case studies. Addressing the doctrine of the absolute sanctity of life, Singer and Kuhse examine some actual cases where decisions have been reached; consider the criteria for making these decisions; investigate the differences between killing and letting die; compare Western attitudes and practices with those of other cultures; and conclude by proposing a decision-making framework that offers a rational alternative to the polemics and confusion generated by this highly controversial topic. (shrink)

In _The Moral of the Story,_ Peter and Renata Singer draw on some of the best works of fiction, playwriting, and poetry in order to shed light on the perennial questions of ethics. A vivid montage of literature that touches on a broad range of ethical subjects and themes Offers a unique contribution to the study of moral philosophy and literature Demonstrates how literary sources can add richness to discussions of real-life moral questions and dilemmas Brings together selections (...) and excerpts from the world’s most celebrated short stories, novels, plays, and poetry Features substantive section introductions by Peter and Renata Singer Peter Singer is a leading moral philosopher, widely credited with triggering the modern animal-rights movement. His collection of essays, _Unsanctifying Human Life,_ edited by Helga Kuhse, was published by Blackwell Publishing in 2001. (shrink)

Impartialism in ethics has been said to be the common ground shared by both Kantian and utilitarian approaches to ethics. Lawrence Blum describes this common ground as follows: Both views identify morality with a perspective of impartiality, impersonality, objectivity and universality. Both views imply the ‘ubiquity of impartiality” – that our commitments and projects derive their legitimacy only by reference to this impartial perspective.

This second edition of _A Companion to Bioethics,_ fully revised and updated to reflect the current issues and developments in the field, covers all the material that the reader needs to thoroughly grasp the ideas and debates involved in bioethics. Thematically organized around an unparalleled range of issues, including discussion of the moral status of embryos and fetuses, new genetics, life and death, resource allocation, organ donations, AIDS, human and animal experimentation, health care, and teaching Now includes new essays on (...) currently controversial topics such as cloning and genetic enhancement Topics are clearly and compellingly presented by internationally renowned bioethicists A detailed index allows the reader to find terms and topics not listed in the titles of the essays themselves. (shrink)

The expanded and revised edition of _Bioethics: An Anthology_ is a definitive one-volume collection of key primary texts for the study of bioethics. Brings together writings on a broad range of ethical issues relating such matters as reproduction, genetics, life and death, and animal experimentation. Now includes introductions to each of the sections. Features new coverage of the latest debates on hot topics such as genetic screening, the use of embryonic human stem cells, and resource allocation between patients. The selections (...) are independent of any particular approach to bioethics. Can be used as a source book to complement _A Companion to Bioethics_. (shrink)

The association of women with caring dispositions and thinking has become a persistent theme in recent feminist writing. There are a number of reasons for this. One reason is the impetus that has been provided by the empirical work of Carol Gilligan on women’s moral development. The fact that this association is not merely an ideologically or philosophically postulated one, but is argued for on empirical grounds, tends to add to its credibility. Another reason for the resilience of the association (...) is the existence of an increasingly prominent theme in feminist thought and action that focuses on the importance of women’s difference from men, both as a fact and as a goal. Within this theme, there are various views on what the relevant differences are between women and men, and why the differences ought to be emphasized and properly respected. Women’s caring, as will be seen, turns out to have a firm presence in all of these views, and as a result, many women argue that caring should form the basis of a distinctive feminist ethic. On these views, women’s approaches to understanding moral situations, defining selfconceptions, choosing goals and roles, and guiding behaviour, should all be informed by and based upon dispositions of caring. However, if this idea of a feminist ethic of care is to be plausible, it will need to be reconciled with another strong theme in feminism, according to which in fundamental moral respects women ought not be considered or treated differently from men. We will examine the standing of a feminist ethic of care in the context of this tension between the difference theme and the sameness theme in feminism. The discussion begins by re-characterizing the justice and care debate in terms of impartialist and partialist ethical perspectives, and it then goes on to indicate the various ways in which women’s presumed disposition to caring and partialism finds prominence within the difference theme. The central focus of the discussion, however, will be the question of how to reconcile the conflict that exists between impartialist, justice-based moral thinking, and a partialist, caring approach to morality.. (shrink)

This chapter contains sections titled: Medical Ethics Nursing Ethics Bioethics References.

New developments in reproductive technology have made headlines since the birth of the world's first in vitro fertilization baby in 1978. But is embryo experimentation ethically acceptable? What is the moral status of the early human embryo? And how should a democratic society deal with so controversial an issue, where conflicting views are based on differing religious and philosophical positions? These controversial questions are the subject of this book, which, as a current compendium of ideas and arguments on the subject, (...) makes an original contribution of major importance to this debate. (shrink)

This article presents an empirical study of approaches to ethical decision-making among nurses and doctors. It takes as its starting point the distinction between the perspectives of care and of justice in ethical thinking, and the view that nurses' thinking will be aligned with the former and doctors' with the latter. It goes on to argue that the differences in these approaches are best understood in terms of the distinction between partialist and impartialist modes of moral thinking. The study seeks (...) to determine the distribution of these modes of thinking between nurses and doctors, and finds that there are no signif icant differences between them. A 'two-level' philosophical view of the nature of moral thinking is appealed to in order to explain the study findings. (shrink)

We examine the view that all human life is of equal worth or sanctity. We find that this view is a legacy of the Judeo- Christian tradition, and cannot be justified in non - religious terms. We therefore argue that it should be rejected, and that we should openly acknowledge that some Jives are of less worth than others. We then consider a common objection: that this will lead us down a slippery slope to Nazi- style atrocities. We give our (...) reasons for finding this objection unpersuasive. We explain why no-one has any grounds for feeling threatened by our proposal. Finally we discuss who should make the decision involved in selecting whether a person should come into existence, and how that decision should be carried out. (shrink)

What proportion of available healthcare funds should be allocated to hip replacement operations and what proportion to psychiatric care? What proportion should go to cardiac patients and what to newborns in intensive care? What proportion should go to preventative medicine and what to treating existing conditions? In general, how should limited healthcare resources be distributed If not all demands can be met?

To give priority to the young over the elderly has been labelled ‘ageism’. People who express ‘ageist’ preferences may feel that, all else equal, an individual has greater right to enjoy additional life years the fewer life years he or she has already had. We shall refer to this as egalitarian ageism. They may also emphasise the greater expected duration of health benefits in young people that derives from their greater life expectancy. We may call this utilitarian ageism. Both these (...) forms of ageism were observed in an empirical study of social preferences in Australia. The study lends some support to the assumptions in the QALY approach that duration of benefits, and hence old age, should count in prioritising at the budget level in health care. (shrink)

To give priority to the young over the elderly has been labelled ‘ageism’. People who express ‘ageist’ preferences may feel that, all else equal, an individual has greater right to enjoy additional life years the fewer life years he or she has already had. We shall refer to this asegalitarian ageism. They may also emphasise the greater expected duration of health benefits in young people that derives from their greater life expectancy. We may call thisutilitarian ageism. Both these forms of (...) ageism were observed in an empirical study of social preferences in Australia. The study lends some support to the assumptions in the QALY approach that duration of benefits, and hence old age, should count in prioritising at the budget level in health care. (shrink)

Since 1989 there has been an ongoing controversy about the limits of public discussion of bioethical issues in the German-speaking world. While a number of scholars have been involved, Peter Singer and Helga Kuhse have been the principal targets of those seeking to limit bioethical debates. Those who have supported silencing discussion of certain issues have argued that such public discussion leads to a loss of freedom. In the article we argue that toleration is not based on (...) subjectivism but rather on reason. Furthermore, the efforts to suppress debate are often based on a failure to understand our position. Such efforts at suppression also rest on an elitist view of society that must assume that the general public cannot debate such topics. (shrink)

The difficulties have arisen because of the claim Bush made in his 2003 State of the Union Address that Iraq was seeking to buy uranium from Africa. Already in October, 2002, a secret Central Intelligence Agency (CIA) document, the "National Intelligence Estimate on Iraq," said that "claims of Iraqi pursuit of natural uranium in Africa are, in [the assessment of the State Department's Bureau of Intelligence and Research] highly dubious."1 That month, the CIA sent two mcmos to the White House (...) voicing doubts about the claims. One went to Bush's deputy national security adviser, Stephen J. Hadley, and the other to his chief speechwriter, Michael Gerson. CIA Director George J. Tenet also phoned Hadley before the president was to make a speech in Cincinnati, on October 7, asking that the allegation be removed.2 Nevertheless, three months later the claim made its way into the most solemn speech that the president gives each year. By making the claim, Bush misled Congress, the people of the United States, and the world about a central issue in the case he was making for going to war with Iraq. (shrink)

In his book A Charge to Keep, George W. Bush writes of his decision to "recommit my heart to Jesus Christ." He traces it to a walk along the beach in Maine with the Christian evangelist Billy Graham. Conversing with Graham, Bush was "humbled to learn that God had sent His Son to die for a sinner like me." After his decision to recommit himself to Jesus, Bush tells us, he began to read the Bible regularly and joined a Bible (...) study group. (shrink)

What is ethics? Where do moral standards come from? Are they based on emotions, reason, or some innate sense of right and wrong? For many scientists, the key lies entirely in biology---especially in Darwinian theories of evolution and self-preservation. But if evolution is a struggle for survival, why are we still capable of altruism? In his classic study The Expanding Circle, Peter Singer argues that altruism began as a genetically based drive to protect one's kin and community members (...) but has developed into a consciously chosen ethic with an expanding circle of moral concern. Drawing on philosophy and evolutionary psychology, he demonstrates that human ethics cannot be explained by biology alone. Rather, it is our capacity for reasoning that makes moral progress possible. In a new afterword, Singer takes stock of his argument in light or recent research on the evolution of morality.--Publisher's description. (shrink)

Since its original publication in 1975, this groundbreaking work has awakened millions of people to the existence of "speciesism"—our systematic disregard of nonhuman animals—inspiring a worldwide movement to transform our attitudes to animals and eliminate the cruelty we inflict on them. In Animal Liberation, author Peter Singer exposes the chilling realities of today’s "factory farms" and product-testing procedures—destroying the spurious justifications behind them, and offering alternatives to what has become a profound environmental and social as well as moral (...) issue. An important and persuasive appeal to conscience, fairness, decency, and justice, it is essential reading for the supporter and the skeptic alike. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Peter Singer and Christian Ethics: Beyond Polarization by Charles E. CamosyWerner WolbertPeter Singer and Christian Ethics: Beyond Polarization CHARLES E. CAMOSY Cambridge: Cambridge University Press, 2012. 278 pp. $29.99Peter Singer’s “Copernican revolution” against a sanctity of life ethic may be regarded, from a Roman Catholic viewpoint, as an expression of the “culture of death” denounced by John Paul II. One must keep in mind, (...) however, that “we know that historically there have been times where those participating in discussions about ethics disagree deeply about theory, but nevertheless come to important and even broad agreement about applied or practical ethics” (179). The aim of Camosy’s book is to sketch the various areas of agreement and disagreement between Peter Singer and Catholic moral theology as well as the possibilities of working together.There are issues even about the subject of abortion on which Singer and the Church agree: that moral relativism is wrong; that it is seriously wrong to kill a person; that the right to privacy (see Roe vs. Wade) does not apply to acts harming others; and that the right to abortion is not a constitutional matter (chapter 1). Both positions see a connection between abortion and infanticide, but both draw different conclusions. The disagreements between them are about who is to count as a person, which Camosy comments on in the rest of chapter 1 (27–37). In the area of euthanasia, the Church and Singer share some skepticism about brain death (chapter 2). Camosy discusses the church’s position on one’s moral status at the end of life and the Roman Catholic understandings of ordinary and extraordinary means, acts, and omissions. Commenting on public policy in that field, Camosy gives some useful and convincing illustrations of the slippery slope effect in different countries that have legalized active euthanasia or assisted suicide (68–81).With regard to problems of killing, however, Helga Kuhse’s The Sanctity of Life Doctrine in Medicine (Oxford University Press, 1987) should perhaps have been considered. On the subject of acting and refraining, I would recommend Dieter Birnbacher’s Tun und unterlassen (Reclam 1995).Commenting on Singer’s championing of the moral status of nonhuman animals, Camosy points to elements in the Christian tradition that may support Singer’s issue of animal liberation (chapter 3). I wonder why the discussion concentrates on domestic animals and the problems of eating meat or [End Page 225] vegetarianism but omits problems of environmental ethics (e.g., ecological balance). Would the aim of avoiding animal harm include saving animals from predators? And if some animals are to be regarded as persons, we may get in trouble with our basic conviction of the equality (of the dignity) of human beings—as the debate on the margins of human life shows.Duties to the poor are not in dispute except for “partial preferences” (166) for members of our family, kinship, or country (chapter 4). Speaking of “partiality” in this context is, however, a bit misleading. Since no one can care for all people, preferences of an ordo caritatis (order of love) are a necessary part of a system of coordination from which—ideally—all humans can benefit. (Recall Augustine in De doctrina Christiana, 1.28–29: “The interests of society, however, and its common bonds will be best conserved if kindness be shown to each individual in proportion to the closeness of his relationship.”) Chapter 5, which compares Singer’s ethical theory with Catholic moral theology, would need more discussion (e.g., on double effect, object, and act), which I cannot cover within the limits of this review. Overall, Camosy’s book makes a valuable contribution to the dialogue between Christian and secular ethics.Werner WolbertUniversity of SalzburgCopyright © 2014 Society of Christian Ethics... (shrink)

The use of the Quality Adjusted Life-Year (QALY) as a measure of the benefit obtained from health care expenditure has been attacked on the ground that it gives a lower value to preserving the lives of people with a permanent disability or illness than to preserving the lives of those who are healthy and not disabled. The reason for this is that the quality of life of those with illness or disability is ranked, on the QALY scale, below that of (...) someone without a disability or illness. Hence we can, other things being equal, gain more QALYs by saving the lives of those without a permanent disability or illness than by saving the lives of those who are disadvantaged in these ways. But to do so puts these disadvantaged people under a kind of double jeopardy. Not only do they suffer from the disability or illness, but because of it, a low priority is given to forms of health care that can preserve their lives. This, so the objection runs, is unjust or unfair. This article assesses this objection to the use of QALYs as a basis for allocating health care resources. It seeks to determine what is sound in the double jeopardy objection, and then to show that the defender of QALYs has an adequate response to it. (shrink)

In the Brazilian film "Central Station," Dora is a retired schoolteacher who makes ends meet by sitting at the station writing letters for illiterate people. Suddenly she has an opportunity to pocket $1,000. All she has to do is persuade a homeless 9-year-old boy to follow her to an address she has been given. (She is told he will be adopted by wealthy foreigners.) She delivers the boy, gets the money, spends some of it on a television set and settles (...) down to enjoy her new acquisition. Her neighbor spoils the fun, however, by telling her that the boy was too old to be adopted —he will be killed and his organs sold for transplantation. Perhaps Dora knew this all along, but after her neighbor's plain speaking, she spends a troubled night. In the morning Dora resolves to take the boy back. (shrink)

OBJECTIVES: To determine the relationship between ethical reasoning and gender and occupation among a group of male and female nurses and doctors. DESIGN: Partialist and impartialist forms of ethical reasoning were defined and singled out as being central to the difference between what is known as the "care" moral orientation (Gilligan) and the "justice" orientation (Kohlberg). A structured questionnaire based on four hypothetical moral dilemmas involving combinations of (health care) professional, non-professional, life-threatening and non-life-threatening situations, was piloted and then mailed (...) to a randomly selected sample of doctors and nurses. SETTING: 400 doctors from Victoria, and 200 doctors and 400 nurses from New South Wales. RESULTS: 178 doctors and 122 nurses returned completed questionnaires. 115 doctors were male, 61 female; 50 nurses were male and 72 were female. It was hypothesised that there would be an association between feminine subjects and partialist reasoning and masculine subjects and impartialist reasoning. It was also hypothesised that nurses would adopt a partialist approach to reasoning and doctors an impartialist approach. No relationship between any of these variables was observed. (shrink)

In earlier publications, we had argued that Paul Ramsey is inconsistent because he simultaneously asserts that (i) 'all our days and years are of equal worth' and (ii) 'that it is permissible to refrain from prolonging the lives of some dying patients'. Thomas Long has suggested that we have not shown that Paul Ramsey is inconsistent. Ramsey and we, he holds, start from incommensurable metaphysical views: for Ramsey, the dying process has religious significance--God is calling his servant home. While it (...) is normally a good thing to keep a patient alive, it would, for Ramsey, show deafness to God's call to keep a dying patient alive. It is true we do not share Paul Ramsey's religious views. It is, however, not necessary to rely on any particular metaphysical views to refute Ramsey's position. For Ramsey's view to be internally consistent, Ramsey would have to be able to distinguish between dying and non-dying patients. We examine some of Ramsey's examples and show that his practical judgements do not allow us to draw this distinction. This means that, contra Long, we hold fast to our charge that Ramsey's view is inconsistent. (shrink)

Medicine and health care generate many bioethical problems and dilemmas that are of great academic, professional and public interest. This comprehensive resource is designed as a succinct yet authoritative text and reference for clinicians, bioethicists, and advanced students seeking a better understanding of ethics problems in the clinical setting. Each chapter illustrates an ethical problem that might be encountered in everyday practice; defines the concepts at issue; examines their implications from the perspectives of ethics, law and policy; and then provides (...) a practical resolution. There are 10 key sections presenting the most vital topics and clinically relevant areas of modern bioethics. International, interdisciplinary authorship and cross-cultural orientation ensure suitability for a worldwide audience. This book will assist all clinicians in making well-reasoned and defensible decisions by developing their awareness of ethical considerations and teaching the analytical skills to deal with them effectively. (shrink)

How are we to decide where our scarce medical resources are most effectively spent? The notion of a quality-adjusted-life-year has been proposed as a way of doing this. Some economists appear to think that this can be done without making ethical assumptions. We examine the application of this notion to the treatment of premature newborns, and especially to comparisons between the value of medical care for newborns, and the value of medical care for older people. We find that some highly (...) questionable ethical assumptions are inovled in such comparisons. (shrink)

ABSTRACT In Germany, applied ethics is under attack from a diverse coalition of left‐wing organisations, disability groups, and some conservative defenders of a strict doctrine of the sanctity of human life. The attack has been pressed to the point of forcing the cancellation of conferences and disrupting lectures or classes so that they cannot take place. This essay describes the extent and nature of the attack, and makes a preliminary assessment of its significance.

For this special issue dedicated to Jonathan Glover, Peter Singer was asked to reflect on the influence that the book Causing Death and Saving Lives had on him, as well as the Glover seminar in Oxford that Peter Singer attended in the late 1960s. One of Peter Singer's recurring arguments is the criticism of the traditional distinction between acts and omissions. But Glover is no stranger to this questioning, even if the two thinkers do (...) not seem to want to draw exactly the same conclusions. What is at stake is this: what are we really responsible for and how demanding should our morality be? (shrink)